CPT 97750: Physical Performance Evaluation and Report
Medicare pays $35 and commercial payers pay $53 on average nationally for this procedure.
CPT code 97750 describes a physical performance evaluation in which the provider assesses musculoskeletal and functional capacity through tests and activities of daily living and completes a written report; the service is categorized as a physical medicine and rehabilitation evaluation/testing service typically provided in outpatient clinic or therapy settings where functional performance and ADL capabilities are measured.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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National Reimbursement Benchmarks
Medicare's national mean of $35 sits below BUCA's commercial average of $52.6, indicating that average commercial reimbursements for CPT 97750 exceed Medicare by about $17.6. The median Medicare local rate is $34 while BUCA's median is $45.7, further underscoring higher central tendency in BUCA commercial arrangements versus Medicare locality averages.
Dispersion varies materially across payers: Blue Cross Blue Shield shows the widest interquartile spread with P75–P25 = $31.2 ($75.5–$46.3), followed by UnitedHealth Group at $14.9 ($44.9–$30.4). Aetna displays a relatively tight spread of $9.0 ($31.0–$22.0), and Cigna's spread is $25.1 ($52.5–$27.4). BUCA's IQR is $22.6 ($61.5–$37.9) and Medicare's IQR is $3 ($36–$33), making Medicare the tightest by this measure.